青光眼合并白内障手术方式选择及远期效果观察  

Observation of the surgical options and long-term effect of cataract combined with glaucoma

作　　者：郭哲锋 曲验兵 

机构地区：[1]运城市眼科医院,044000

出　　处：《中国实用眼科杂志》2017年第4期408-410,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨青光眼合并白内障的手术方式选择,并观察其远期临床效果.方法 选择2011年8月至2015年6月在运城市眼科医院就诊的青光眼合并白内障的住院病例157例（183只眼）.其中,以青光眼入院合并白内障的123例（131只眼）,以白内障入院发现青光眼的34例（52只眼）.原发性急性闭角型青光眼78例（87只眼）、原发性慢性闭角型青光眼32例（47只眼）、原发性开角型青光眼3例（4只眼）、白内障继发青光眼21例（21只眼）,残余性青光眼并发白内障23例（24只眼）.根据发病原因、病程、房角关闭程度等选择不同的手术方式,随诊＞6个月,观察治疗效果.结果 行白内障青光眼联合手术的37例（41只眼）（22.4％）,行白内障手术的62例（73只眼）（39.9％）,行青光眼手术的58例（69只眼）（37.7％）.136例（171只眼）（93.4％）不用或加用1-2种局部降眼压药眼压控制满意,11例（12只眼）（6.6％）行二次抗青光眼手术.无严重并发症发生.结论 对于青光眼合并白内障的病例,应根据病情选择不同的手术方式,最大限度的提高手术成功率,减轻患者的痛苦.Objective To explore the surgical approach of glaucoma combined with cataract and to observe its long-term clinical effect.Methods A total of 157 patients （183 eyes） with glaucoma combined with cataract were selected.Among them,123 cases （131 eyes） of cataract were found by glaucoma admission,34 cases （52 eyes） of glaucoma were found by cataract admission.There were 78 cases （87 eyes） of primary acute angle-closure glaucoma,32 cases （47 eyes） of primary chronic angle-closure glaucoma,3 cases （4 eyes） of primary open-angle glaucoma,cataract secondary glaucoma in 21 cases （21 eyes）,residual glaucoma complicated with cataract in 23 cases （24 eyes）.According to the cause of the disease,the course of disease,the degree of angle closure to choose different surgical methods,follow-up 〉 6 months to observe the treatment effect.Results Of 37 patients （41 eyes） underwent cataract surgery combined with glaucoma surgery （22.4%）,62 patients （73 eyes） underwent cataract surgery （39.9%） and 58 patients （69 eyes） underwent glaucoma surgery （37.7%）.The intraocular pressure control was satisfactory in 136 cases （171 eyes,93.4%） by not using or using 1-2 kinds of local reduction of intraocular pressure drugs,11 cases （12 eyes,6.6%） underwent secondary anti-glaucoma surgery.No serious complications occurred.Conclusions Various surgery approach for glaucoma with a cataract should be chosen depending on the different conditions.The success rate of operation should be improved to the maximum extent and the pain of the patients should be alleviated.

关 键 词：白内障继发青光眼 临床效果 手术方式 残余性青光眼 房角分离术 

分 类 号：R775.2[医药卫生—眼科]